100mg is pretty much the minimum that might work. Some need a lot more. A few need less
Almost everyone feels like crap for 6-8 weeks
These tests should have been done be commencing with TRT, you needed to know where estrogen sits in order to design you protocol. You are in fact flying blind and you have no idea if you are going in the right direction.
If your thyroid is underperforming and/or estrogen is elevated pre-TRT, you have to start this process from scratch because everytime you make a change to your protocol, it takes another 6 weeks to reach stable levels.
Unfortunately I did not know much about TRT until after I started and apparently my doctor knows little to nothing as well. Especially given my family history of Hypothyrodism (Both my mother and sister take synthroid). Do I just wait this out?
This is why so many men struggle for months on end or quit TRT altogether. Your average doctor doesn’t know anything and this forces the patient to figure everything out. Until now doctors believed TRT cause prostate cancer and heart attacks, some still do, so most doctors TRT is a blind spot and they’re not going to go back to school to learn.
I agree with many giving up due to a lack of information in the medical field among doctors. Before I was prescribed Test-C my doctor wrote a prescription for Wellbutrin XL which I took for about 2 weeks…My doctor said it must be depression causing my mood, fatigue, and libido to suffer… I was the one who demanded my doctor test for Free T levels. Turns out I was right and they were low.
Very possible.
Wellbutrin alters brain hormones, TRT increase testosterone, estrogen, DHT and testosterone greatly influence dopamine. If low testosterone is causing low dopamine, the correct treatment is TRT, not Wellbutrin, but doctors are taught to treat the symptoms and the cause of your symptoms is never addressed.
Lots of men who have depression actually have low testosterone and aren’t getting the proper treatment. Thyroid problems also causes depression, but a lot of doctors tell their patients their levels are normal when they actually have a problem but their heads are stuck in these sick care reference ranges, which continue to narrow over the years.
If you have depression, but your doctor needs to find out why.
Especially since my Total test naturally was 382 versus a free T of 53.3 PG/ML it seems like I might require much higher total testosterone levels (although my SHBG is 30) to reach the upper limit of free T (where I presumably will feel better). I think the best course of action for me will be to stick with the current dosing and wait until my labs are done in 3 weeks. I see some people barely are at 500 trough on 50mg 2x weekly. Guess we will find out here soon where I sit…
This is very true… Low Dopamine is associated with low libido and overall lower mood. That is why Wellbutrin XL increases libido due to the fact that it drives Dopamine higher. However my doctor foolishly was just masking the root cause of my low dopamine which was low T. Seems like they would rather write prescriptions for nasty anti-depressants than address the root cause of low dopamine and the symptoms that follow. There is clearly a reason depression AND low T lead to the same dysfunctional set of symptoms and that reason is likely correlated to dopamine levels and pathways.
Yes, this to me would be your best course of action. You very well may not have enough, but you won’t know until labs. As systemlord stated earlier, you could be on an upward trajectory from here though as it builds up in your system.
What they want to do is practice within established protocols based on the evidence. Part of the evidence is what they were taught and they are taught that testosterone levels within lab ranges is normal and treatment is not indicated. Pharmaceutical companies publish research which supports utilization of their products which have been approved by the FDA (based on the research) for certain conditions.
One piece of evidence based medicine is the wants (expectations) and desires of the patient. I suspect as time moves on we will see a different outlook on this by mainstream practitioners. I’m even aware of a few guys who have moved to their PCP after starting with a hormone clinic after the patients report how well they are doing. The doctor simply takes over writing the same prescription.
On top of patient demand, another part of evidence based medicine is the best available research in the literature and while still less than ideal, research into hormone restoration is increasing.
Interesting times.
Some of these SSRIs hammer your testosterone levels.
@systemlord @highpull and to anyone else who is following along
Today is an extension of yesterday… except much worse. My eyes feel as though I am “High” and anxiety is through the roof as well as severe fatigue/shakiness and brain fog. Although this morning I had some great morning wood. This roller coaster ride is severely taking a toll on my work performance as co-workers are noticing. Does this sound like too low T dosage and/or low e2 ?? Ever since the intital “honey-moon” phase which lasted all of a week, I have seriously dropped to a low point… I want to wait this out and stick to my current dosage but I am at the point where I can barely function at work and do my job correctly. Which is important in my line of work.
Too low.
I have found that making dosage adjustments without labs can cause you to get lost and before you know it 6 months has gone by and you have nothing to show for being on TRT for 6 months. I still can’t tell if I’m having high or low E2 and I’ve been doing this awhile.
High and low E2 are very similar, both have anxiety, both have joint pain but are polar opposites. The low E2 anxiety is different, racing thoughts, high estrogen anxiety is irritability, but slowed thinking and brain fog.
I understand, however I fear I am endangering the public while feeling like this… I know that if I bump dosage now I will be basically pushing the reset button on my 6 week time frame. But if I can gain a little symptom relief it might be worth trying? I am losing it over here
Do you thoughts feel foggy and slow, or are your thoughts racing through your head?
I would say foggy and slow. My eyes feel sunken and I feel stoned. I feel like I am running on two brain cells. I feel like I am in fight or flight mode 24/7
There is no way to tell from this alone. From my personal experience I have racing thoughts, brain fog and slowmo feeling on both low and high E2.
High E2 almost makes me blind though. Like I’m drunk and high at the same time. Low E2 has horrible brain fog, but much clearer vision.
I have the money to run blood work now… should I draw up labs tomorrow and see?